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Laser surgery treats laryngeal and tracheal growths less invasively

BioPhotonicsSep 2007
According to the National Institutes of Health, about 7.5 million people in the US have voice problems. Laryngeal and tracheal growths — a major cause of voice disorders — traditionally are removed surgically under general anesthesia. These growths have a tendency to reappear and often require multiple surgeries. They also can cost patients a few days of recovery time.

Dr. Jamie A. Koufman, director of the Voice Institute of New York in New York City, and her colleagues evaluated the use of unsedated office-based laser surgery with three lasers to see how well the minimally invasive technique worked in comparison with the traditional surgery.

As presented in the July issue of Otolaryngology — Head and Neck Surgery, the researchers tested 170 patients with 443 cases of laryngeal or tracheal problems, such as papillomas and granulomas, with either a 585-nm pulsed-dye laser, a 10.6-μm flexible CO2 laser or a 2000-nm Tm:YAG laser, or with a combination of these (depending on the condition). They used a 5.1-mm-wide transnasal esophagoscope from Pentax Medical Co. of Montvale, N.J., to deliver the appropriate laser to the growths. The procedure typically took between 15 and 45 minutes.

The researchers found that 99.1 percent of the cases were treated effectively without any complications. Four cases (0.9 percent) had minor complications, as compared with the traditional surgery’s complication rate of about 3 percent.

The researchers believe that their results indicate that office-based laser surgery is both a safe and effective method for patients. They also note that, unlike traditional surgery with general anesthesia, most patients can drive home and return to work immediately after the procedure.

A laser with a gain medium consisting of an organic dye, which is carbon-based. The dye is mixed with a solvent, allowing the molecules to diffuse evenly throughout the liquid. The dye medium is capable of producing a larger range of wavelengths compared to gain mediums composed of gas. Thus, dye lasers are commonly used to obtain high bandwidth in tunable/pulsed lasers.